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Author
Topic: Superinfection! Is it real and what causes it? (Read 37075 times)

I'm of the opinion the whole argument stems from the question: What is a super-infection?I understand that people want to hear: "It's ok to bareback someone thats HIV+"The argument is always "There are no real documented cases of Super-infection"

Newt I kinda like your definition. People will always hear what they want to hear, and refuse to hear what they don't want to hear.Bottom line is no one wants to hear adding a different mutation into the mix can be bad.

Forget Keisha, where is SD Girl, Aidsmeds own reigning queen of mean. I suspect she might be flying on her broom somewhere over San Diego as we speak, or should I say, type.

She is always good at chewing someone a new one whenever that person stands up against the group think so prevalent on this website.

Some of you sound like a bunch of trash talking seventh grade girls, trying to sound so hard core, when in fact you are merely insecure children hiding from your own boogeymen.

I love when the crew of Aupoint and Silly Philly strap on board. You girls don't have a lot going on in your personal life do you, that is, to have so much time to troll this website. Many of us are growing bored with your rantings.

SDGirl is NOT the queen of mean and please take care not to attack her or anyone on this site. I admittedly have no powers to do anything about it but I do know SD girl and she is an extremely beautiful person inside and out. She stands up for what she believes in as do others. I for one would LOVE to have her back and she is slowly getting there, for those of you in the know, she has a new blog up. I got your back SD, get your ass back here! Also Koi and Scott, please remember....

« Last Edit: February 12, 2007, 12:47:42 PM by ACinKC »

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LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

Again, it's a question of statistics and probabilities, but the result of "super-infection" would be the same: you acquire and persist virus with a genetic profile different from the bugs you have. The only way that happens is if the new bugs are resistant to meds you are taking.

While sensational alarms over "super-virus" have caused many to be suspicious of super-infection claims, I would venture that treatment failures over the last ten years have been more due to super-infection, rather than the course of a subject's own bugs. That a clinician would not not think this to be the case suggests that s/he has either not seen treatment failures or thought much about the sex lives of the people s/he treats.

So, my questions are as follows.

If one has contracted two strains of HIV that are both not resistant to any meds, is that still super-infection?

And is contracting just one strain of resistant HIV as bad or worse as contracting two that aren't resistant?

If one has contracted two strains of HIV that are both not resistant to any meds, is that still super-infection?

And is contracting just one strain of resistant HIV as bad or worse as contracting two that aren't resistant?

1. Yes. though the concern from a treatment perspective for any disease is drug resistance.

2. Yes, because you have lost at least one class of weapons agains the virus...assuming the non-resiistant strains are not endowed with super powers that let them avoid any attempts at extermination with or without drugs. Virus that can bend time and space is a real bitch to deal with, and so is the stuff spliced with Dalek DNA!

1. Yes. though the concern from a treatment perspective for any disease is drug resistance.

2. Yes, because you have lost at least one class of weapons agains the virus...assuming the non-resiistant strains are not endowed with super powers that let them avoid any attempts at extermination with or without drugs. Virus that can bend time and space is a real bitch to deal with, and so is the stuff spliced with Dalek DNA!

Stupid flux-capacitor equipped virus!

OK... so if someone is hypothetically infected with two non-resistant strains of HIV... what's so bad about that?

I have been thinking...if you have unprotected sex with an HIV partner and you are both undetectable and on the same meds...and still get reinfected....That means that the virus you have passed to or received from your partner is resistant to those meds you are both taking. If not, it would have been totally suppressed or weakended and unable to cause reinfection. In that case you would have a new strain resistant to the meds you are taking and therefore less treatment options. Isnīt it?My Dr. warned me about reinfection.

I would think that if one were to have 2 non resistent viruses that they could mutate differently at diff times. I would think that would be a BITCH to control.

Imagine having one red headed step child.....now add a second. Body surely would lose (notice the spelling of lose not LOOSE, sorry just a pet peeve) this battle quicker than if it was just taking on one at a time.

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LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

Again, it's a question of statistics and probabilities, but the result of "super-infection" would be the same: you acquire and persist virus with a genetic profile different from the bugs you have. The only way that happens is if the new bugs are resistant to meds you are taking.

Well not quite I think.

For one, possibly, most of the treatment failures over the last 10 years have been because the understanding of the importance of resistance and adherence was poor back in the 1990s, or monotherapy, sub-triple therapy etc led to resistance that compromised treatment, rather than acquired secondary infection. Yes? No? Possible? possible...

For two, everyone's HIV is a mix to start and the balance, well it can change, does change, and careful analysis shows this is at least as likely if not more likely, or indeed the provable, actual cause of sudden viraemia and immune decline rather than bonus bugs from barebacking.

I do not say reinfection can't happen, or more importantly, reinfection with a new type of HIV that affects your treatment/health can't happen, but people who present it as a real and present danger without qualifying this in terms of viral load, regular v irregular partner, anal v vaginal sex, treatment v no treatment, age of HIV infection etc, are basically fudging a real explanation (by lying to their patients usually) of the risk. Or lack of it.

Same HIV subtype, same resistance profile, same treatment history = zero risk. It seems possible you can find this out about your number 1 man/woman but perhaps not in a steam room.

I have been thinking...if you have unprotected sex with an HIV partner and you are both undetectable and on the same meds...and still get reinfected....That means that the virus you have passed to or received from your partner is resistant to those meds you are both taking. If not, it would have been totally suppressed or weakended and unable to cause reinfection. In that case you would have a new strain resistant to the meds you are taking and therefore less treatment options. Isnīt it?My Dr. warned me about reinfection.

That's just dumb! If you're both on the same meds and undetectable you can't create a resistant strain to pass on out of thin air......

Well, clearly this topic is controversial. I've learned a lot already and I see all the usual drama queens and attention whores couldn't even derail the discussion.

I think the fact that all of us have different views on this is interesting. Even down to different definitions. Perhaps I should have titled the thread differently, but I know we've all heard this term tossed around a lot.

With all of the information I've read so far I think it would be interesting if we could have some couples weigh in on the situation?

Seems to me that this whole superinfection topic covers a broad range of issues and concerns.

Why not? I think it is unlikely to pass a strain to another person if you are undetectable, but if you do pass it it might be because those few virons have mutated and are the adan and eve of a new strain that is developing in the host before the host is showing evident signs of resistance by an increased viral load. Maybe I am developing today a resistant starin and I am still undetectable but can pass it to my partner...before knowing I have it.I think the onnly concer about reinfection is acquiring a resistant strain. I you have 200 different strains abut all of them have no resistance to meds, there is nothing to worry about.

Why not? I think it is unlikely to pass a strain to another person if you are undetectable, but if you do pass it it might be because those few virons have mutated and are the adan and eve of a new strain that is developing in the host before the host is showing evident signs of resistance by an increased viral load. Maybe I am developing today a resistant starin and I am still undetectable but can pass it to my partner...before knowing I have it.

But wouldn't that strain have to be present enough in your body for you to be infectious? And furthermore... having HIV antibodies already provides HIV+ people with a certain level of protection from new infections.

I'm getting the feeling that this is a really theoretical discussion... super-infection has happened... but shouldn't it be happening more if it's so easy to get?

Maybe...but HIv is not so easy to pass and look were we are today. We have got it and most of the people donīt. maybe if we made a study of how many people have unpriotected sex and how many get HIV we would also say it is an infection unlikely to happen.

Same HIV subtype, same resistance profile, same treatment history = zero risk.

Only if both treatments are working and containing the virus such that no further mutations are lurking in the shared body fluid, not the blood. Personally, I find negotiating a condom based on other STIs much easier than sequencing virus genes when I hook up with anyone.

Maybe...but HIv is not so easy to pass and look were we are today. We have got it and most of the people donīt. maybe if we made a study of how many people have unpriotected sex and how many get HIV we would also say it is an infection unlikely to happen.

Right... I mean... exposure doesn't equal infection necessarily.

I'm wondering if there are too many variables in this for anyone to speak authoritatively on it. I mean, two people. Are the poz? Are they on meds? Is anyone's virus resistant? How contagious are each of them? How susceptible are they to picking up another strain? How well are their immune systems functioning?

Only if both treatments are working and containing the virus such that no further mutations are lurking in the shared body fluid, not the blood. Personally, I find negotiating a condom based on other STIs much easier than sequencing virus genes when I hook up with anyone.

I brought a picture of MY HIV to see if it matches YOUR HIV! Does yours look like THIS?

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LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

Only if both treatments are working and containing the virus such that no further mutations are lurking in the shared body fluid, not the blood. Personally, I find negotiating a condom based on other STIs much easier than sequencing virus genes when I hook up with anyone.

Ultimately, I think you're right.

What's easier? Putting on a condom or pulling out a DNA sequencer?

"OK... you've got a mutation at K103N... so..."

By that point, the guy you took home the night before is cooking you lunch.

However, if in a monogamous relationship with another poz guy... I wouldn't use protection. But I wouldn't say to other people "you'll be fine" either.

If I recall correctly they were pushing some existing HIV med that was supposed to prevent a partner from getting HIV. The reason I remember it is because at the time I was involved with my negative partner and we'd discussed it if it became an option. Anyways, this pill was like 600/month and I'm not certain, but I thought it was on the market now???

It would seem to me that if they are using some HIV med as a prevention pill then most HIV meds must be acting as a sort of blocker?

Clearly, I see a bigger risk for me (not on meds) with a partner (on meds).

U.S. News has different categories for ranking schools. The ranking among Nationally ranked schools represents the "big leage" of higher education. Local and regional schools are the "lminor leagues" of education. If you look up the 2007 U.S. News ranking of nationally ranked schools you will see that WIlliam and Mary is not present among the top nationally ranked schools. That is the only ranking that really matters, just as the major league in baseball is the only league that really matters. Sure U.S. News throws a bone to smaller less significant schools, but schools such as Harvard, Yale, Stanford and all of the U.C. schools are listed among the major league or nationally ranked schools. Some people in your local region might be impressed by a local school, but in the big city blue states such as California and New York, only nationally ranked schools has the chachet needed to truly impress people. Sorry , that is just how it is.

It demonstrates what a small town girl Aupoint is by being impressed with such unimpressive credentials. It shows your inabiility to distinguish between minor educational institutional rankings and nationally ranked educational institutions. Your inability to comprehend this is funny, I thiink. Go back and look at the list of U.S. News Nationally ranks schools, not the local or regionally ranked schools.

if someone picked up a second strain, would it show up in the resistance tests or is there a specific test you need to do for it?

I think it would show up on the resistance tests.

From what I understand, each strain has a fairly unique genetic profile... but I don't know if, let's say you did pick up a second strain, both profiles (hidden mutations and resistance mutations) would show up as one single profile or as two separate ones.

There is a good summary of the science on Medscape: HIV Superinfection: What Clinicians and Patients Should Know.

The British HIV Association has new guidelines on sexual health for HIV+ people, also have a long section on it (with references), alas a PDF.

Resistance tests look for mutations in a general mixed up viral population. They can't tell if it's an acquired mutuation or one that's come from drug pressure etc, change in viral mix etc. There are tests to do this but they are very complex, lab stuff, not really clinic tests.

On a more human level note, no-one I know in a positive-positive relationship uses condoms (except to prevent babies), and neither do I, regardless of treatment/no treamtment. Quite a few are on the same treatment by design. NB: relationship, not steam room.

There is a good summary of the science on Medscape: HIV Superinfection: What Clinicians and Patients Should Know - you have to register to read it (but it's secretly reprinted here).

The British HIV Association has new guidelines on sexual health for HIV+ people, also have a long section on it (with references), alas a PDF.

Resistance tests look for mutations in a general mixed up viral population. They can't tell if it's an acquired mutuation or one that's come from drug pressure etc, change in viral mix etc. There are tests to do this but they are very complex, lab stuff, not really clinic tests.

So, theoretically, one could be infected with eighteen or so strains, and if none of them are resistant to any medications... no one would really be able to tell if you're infected with however many strains you have?

Everyone makes a good point but, unfortunately is it worth the risK? A friend of mine who lived in NYC recently passed away from some horrible complications... he had contracted I think numerous diseases... KS... which disfigured his face, body etc... he contracted herpes... hpv... and had gonorrhea on more than one occassion... Note... herpes once contracted is with you for life... same as hpv... although treatable ...their not curable...so screw the Bare backing... also he contracted hep A-B... so I think the best scenerio is to practice safe as possible... Everyone on this forum did not practice safe sex at one time or another to contract hiv so why would anyone risk more exposure... even if its a small possibility?

Aupo, (which sounds alot like Alpo so maybe he is kibble and bits for the gay men!) has been EXTREMELY restrained in this thread and I for one am proud of him for it. It has been Koi and his partner Scott instigating at every turn. (Boo has kept the embers burning occaisonally as well!) These two have added NOTHING to this thread and offer little much to the forum as a whole. I am sorry to veer off topic but Scott just did it again and man its got my panties in a bunch. I hope the mods take note to scott and koi (although he has stopped for a bit) and have a little chat with them. I am not for giving time outs as I genereally like everyones opinion on things, but they do need to be addressed.

Off the soap box and with apologies to all others posting on the real discussion. I'd LOVE to experience unprotected sex again! One of you hotties call my wife and set it up will ya!?!?!?!?! (edited to also say after reading Dixieman's post you fuckers better bring your STD panel ALL CLEAR with you as well!!!)

« Last Edit: February 12, 2007, 01:59:37 PM by ACinKC »

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LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

Aupo, (which sounds alot like Alpo so maybe he is kibble and bits for the gay men!) has been EXTREMELY restrained in this thread and I for one am proud of him for it. It has been Koi and his partner Scott instigating at every turn. (Boo has kept the embers burning occaisonally as well!) These two have added NOTHING to this thread and offer little much to the forum as a whole. I am sorry to veer off topic but Scott just did it again and man its got my panties in a bunch. I hope the mods take note to scott and koi (although he has stopped for a bit) and have a little chat with them. I am not for giving time outs as I genereally like everyones opinion on things, but they do need to be addressed.

Off the soap box and with apologies to all others posting on the real discussion. I'd LOVE to experience unprotected sex again! One of you hotties call my wife and set it up will ya!?!?!?!?!

ACinKC, I was kididng about especially Aupo. Aupo has a sense of humor, just read all the replies and threads he has posted.

Everyone makes a good point but, unfortunately is it worth the risK? A friend of mine who lived in NYC recently passed away from some horrible complications... he had contracted I think numerous diseases... KS... which disfigured his face, body etc... he contracted herpes... hpv... and had gonorrhea on more than one occassion... Note... herpes once contracted is with you for life... same as hpv... although treatable ...their not curable...so screw the Bare backing... also he contracted hep A-B... so I think the best scenerio is to practice safe as possible... Everyone on this forum did not practice safe sex at one time or another to contract hiv so why would anyone risk more exposure... even if its a small possibility?

Right... which is why I use protection... except for in the case of a monogamous relationship with a poz guy.

Other STDs can't help... any especially now being poz, I think picking up a dose of the clap would be a bit beneath me.

But condoms aren't all that useful in preventing transmission of herpes and HPV.

LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

I don't care to practice safer sex with someone else positive, because I flat out don't care about any possible risk because that supposed risk is virtually non-existant. Can it happen? Yes, but I can also get hit by a meteorite.

On the scale of risk, it's nowhere near risky. It's fear and those badgers, typically the newbies here, don't really understand nor do they seem to want to since they are coming from a perspective of trauma from being newly infected. Blah blah blah. Watching this thread is like being on a Sit & Spinô. Keeps going round and round but you never get anywhere.

But it is amusing to watch the turdburglars.

As for schools, William & Mary is a prestigious school and probably alot damn harder to get into than those supposed 'top ten'. Size does not equate to quality.

Philly you're not so innocent in this either! LOL While I agree with you I should note you have baited them some as well. Not unjustly but you have!

You know I love ya philly! Mmmmmmmm philly, Im hungry time for a Pepperjax run!

« Last Edit: February 12, 2007, 02:16:35 PM by ACinKC »

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LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

LIFE is not a race to the grave with the intention of arriving safelyin a pretty and well-preserved body, but, rather to skid in broadside,thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT ARIDE!!!

As for schools, William & Mary is a prestigious school and probably alot damn harder to get into than those supposed 'top ten'. Size does not equate to quality.

William & Mary, along with University of Virginia, are the most difficult schools to get into in Virginia. They'd be private schools if Virginia had not had an early progressive attitude towards higher learning stemming from Thomas Jefferson.

And yes, I was accepted to both universities (though I declined and went elsewhere.)

Everyone makes a good point but, unfortunately is it worth the risK? A friend of mine who lived in NYC recently passed away from some horrible complications... he had contracted I think numerous diseases... KS... which disfigured his face, body etc... he contracted herpes... hpv... and had gonorrhea on more than one occassion... Note... herpes once contracted is with you for life... same as hpv... although treatable ...their not curable...so screw the Bare backing... also he contracted hep A-B... so I think the best scenerio is to practice safe as possible... Everyone on this forum did not practice safe sex at one time or another to contract hiv so why would anyone risk more exposure... even if its a small possibility?

Matt mentioned no one he knows in a pos/pos relationship is using condoms. Frankly, I don't know any either.

This poster has come up with a scenario which is what would concern me the most, co infections of other STDs now called STI's or whatever.

For those who are having recreational sex with multiple partners I'd never advocate unsafe sex ever. I also agree with Aupo on his statement about the issue of Walk the Talk. Clearly, none of us are advocating unsafe sex, but I think it's an issue those of us already positive wonder about with the various ramifications and then some of these more outlandish theories and new stories.

I'm not gona comment further on the drama queens. It's usually the same little clique of dysfunctional idiots who ruin every thread and I'd encourage the rest of you to report them to the moderators rather than fueling the fire of lunacy!

Clearly, I see a bigger risk for me (not on meds) with a partner (on meds).

The risks are different.

Not on meds: the risk here is that the person on meds has a resistant strain that goes unnoticed eg by routine monitoring, a giant blip (it would have to be a biggie), bad adherence, a strain in a large enough quantity transmit, get a foothold and expand.

On meds: the risk here is that the person not on meds has a strain in a large enough quantity to transmit, get a foothold and expand.

I think the key word here is quantity. The virus needs to be one that can affect disease progression eg resistant type, and unless it's dominating the "senders" viral population it is already in competition with the dominant strain. Which is by definition fitter. So there's a bit a viral war going on for pole position, and getting enough virus up to the pole, and the the question of meds/pre-infection = defense, and all that stuff, plus host factors eg receptivity to infection, route of transmission, coinfections. So....

It is really hard

(a) to put a decent sized number on the risk eg 1 per 500. We're talking low %, if not a fraction of a fraction of a %. As ever, viral load is important, cos more virus = greater risk. There is a point where treated virus becomes "real world" untransmissable, as is witnessed by many studies on transmission in straight couples in Europe and Africa (ie, no transmissions where the person on treatment has a consistently undetectable load). Gay men in serodiscordant relationships are clearly unworthy of being studied, though (we need a gay men's study please).

(b) say which is the "worse" risk, the risk to someone on meds or off. They's just got different implications. One compromises future treatment perhaps, one current.

So, theoretically, one could be infected with eighteen or so strains, and if none of them are resistant to any medications... no one would really be able to tell if you're infected with however many strains you have?

This is what I was wondering.....I mean, are we basically saying that there are a lot of people who could have been superinfected but we don't know because clinic tests can't distinguish between that and natural mutations?